Small cell lung cancer (SCLC) accounts for 15% of lung cancers. Nearly all cases of SCLC are attributable to cigarette smoking, and the remaining cases are presumably caused by environmental or genetic factors. Compared with non-small cell lung cancer, SCLC generally has a more rapid doubling time, a higher growth fraction, and earlier development of widespread metastases. SCLC is highly sensitive to initial chemotherapy and radiotherapy, but most patients eventually die from recurrent disease. These guidelines detail the management of SCLC from initial diagnosis and staging through treatment, and include information on supportive and palliative care. Important updates to the 2008 version include refined categories for performance status and the addition of topotecan as an option for patients who experience relapse.
For the most recent version of the guidelines, please visit NCCN.org
The UCSF Helen Diller Family Comprehensive Cancer Center (cancer.ucsf.edu) continues a substantial growth period that began with its NCI designation in 1999. An anonymous pledge of $150 million in 2007 enabled expanded infrastructure for experimental therapies; enhanced bioinformatics and database systems; new programs in key developing areas; and an emphasis on patient support services, including outpatient symptom management and survivorship programs. Key is the ambitious Investigational Therapeutics Initiative led by Eric J. Small, MD (second photo on cover). In addition to providing augmented clinical research support and funding for an early-phase trials unit, the initiative will include efforts in clinical pharmacology/pharmacogenomics, bioimaging, target validation/biomarkers, and medical informatics.
Also with prominent Center-wide leadership roles are Peter R. Carroll, MD (third photo on the cover), director of strategic planning and clinical services, and Gerrie Shields (fourth photo), administrative director for clinical operations. Led since 1997 by Frank McCormick, PhD, FRS (not pictured), the Center ranks first in California and sixth nationwide in NCI research grants and is home to SPORE grants for breast, prostate, and brain cancers.
Unique within the University of California system in focusing solely on biomedical research and graduate health-science education, UCSF is unusual also in its highly distributed geographic presence, with 5 principal campuses and numerous satellite locations. At its newest campus, UCSF/Mission Bay, the Center will open a second laboratory research building in early 2009, and architectural plans are underway for a major new cancer hospital.